PHYSICIAN RACE AND CARE OF MINORITY AND MEDICALLY INDIGENT PATIENTS

被引:339
作者
MOY, E
BARTMAN, BA
机构
[1] UNIV MARYLAND,SCH MED,DEPT MED,BALTIMORE,MD 21201
[2] UNIV MARYLAND,SCH MED,DEPT EPIDEMIOL & PREVENT MED,BALTIMORE,MD 21201
[3] DEPT VET AFFAIRS MED CTR,BALTIMORE,MD
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 1995年 / 273卷 / 19期
关键词
D O I
10.1001/jama.273.19.1515
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective.-To examine the relationship between physician race and care of racial minority and ethnic minority patients and medically indigent patients. Design.-Secondary analysis of data from the 1987 National Medical Expenditure Survey, a cross-sectional survey of Americans designed to provide national estimates of health care utilization and expenditures. Setting.-A sample representative of the total civilian noninstitutionalized US population with oversampling of minorities and the medically indigent. Patients.-Survey respondents aged 18 years or older who identified a specific physician as their usual source of care (n=15 081, corresponding to a national population estimate of 116 million Americans). Main Outcome Measure.-Identification of a nonwhite physician as usual source of care. Results.-Of adult Americans who identified a usual-source-of-care physician, 14.4% identified a nonwhite physician as that source of care. Minority patients were more than four times more likely to receive care from nonwhite physicians than were non-Hispanic white patients. Low-income, Medicaid, and uninsured patients were also more likely to receive care from nonwhite physicians. Individuals who receive care from nonwhite physicians were more likely to report worse health, visit an emergency department, and be hospitalized. Individuals who receive care from nonwhite physicians reported more acute complaints, chronic conditions, functional limitations, and psychological symptoms as well as longer visits. Conclusions.-Nonwhite physicians are more likely to care for minority, medically indigent, and sicker patients. Caring for less affluent and sicker patients may financially penalize nonwhite physicians and make them particularly vulnerable to capitation arrangements.
引用
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页码:1515 / 1520
页数:6
相关论文
共 52 条
[1]  
[Anonymous], 1993, ACCESS HLTH CARE AM
[2]   RACIAL-DIFFERENCES IN THE USE OF REVASCULARIZATION PROCEDURES AFTER CORONARY ANGIOGRAPHY [J].
AYANIAN, JZ ;
UDVARHELYI, IS ;
GATSONIS, CA ;
PASHOS, CL ;
EPSTEIN, AM .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 269 (20) :2642-2646
[3]   REGULAR SOURCE OF AMBULATORY CARE AND MEDICAL-CARE UTILIZATION BY PATIENTS PRESENTING TO A PUBLIC HOSPITAL EMERGENCY DEPARTMENT [J].
BAKER, DW ;
STEVENS, CD ;
BROOK, RH .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1994, 271 (24) :1909-1912
[4]   RACIAL-DIFFERENCES IN THE INCIDENCE OF CARDIAC-ARREST AND SUBSEQUENT SURVIVAL [J].
BECKER, LB ;
HAN, BH ;
MEYER, PM ;
WRIGHT, FA ;
RHODES, KV ;
SMITH, DW ;
BARRETT, J .
NEW ENGLAND JOURNAL OF MEDICINE, 1993, 329 (09) :600-606
[5]   PERFORMANCE OF A 5-ITEM MENTAL-HEALTH SCREENING-TEST [J].
BERWICK, DM ;
MURPHY, JM ;
GOLDMAN, PA ;
WARE, JE ;
BARSKY, AJ ;
WEINSTEIN, MC .
MEDICAL CARE, 1991, 29 (02) :169-176
[6]   PREVALENCE OF OBESITY IN AMERICAN-INDIANS AND ALASKA NATIVES [J].
BROUSSARD, BA ;
JOHNSON, A ;
HIMAS, JH ;
STORY, M ;
FICHTNER, R ;
HAUCK, F ;
BACHMANCARTER, K ;
HAYES, J ;
FROHLICH, K ;
GRAY, N ;
VALWAY, S ;
GOHDES, D .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 1991, 53 (06) :S1535-S1542
[7]  
BYRD WM, 1994, J NATL MED ASSOC, V86, P191
[8]   YOUNG PHYSICIANS AND THE FUTURE OF THE MEDICAL-PROFESSION [J].
COHEN, AB ;
CANTOR, JC ;
BARKER, DC ;
HUGHES, RG .
HEALTH AFFAIRS, 1990, 9 (04) :138-148
[9]  
COHEN JW, 1993, INQUIRY-J HEALTH CAR, V30, P281
[10]  
COHEN S, 1991, US PHS AHCPR910037 P